Frectenomies are the removal of a small fold of connective tissue. Most frenectomies are performed in the mouth and can be done with only topical anesthetic. Some dentists find that they can perform a laser frenectomy without any anesthesia, but many patients find that the use of topical anesthetic makes the procedure easier. The use of infiltrative anesthesia for frenectomy is usually unnecessary and a topical anesthetic is sufficient to improve patient comfort. In cases where infiltrative anesthesia is required, a topical anesthetic can be used to make the injection easier.
How a Frenectomy Impacts Patients
Frenectomy is a simple procedure that is most often performed on infants and children. The two types of frenectomies performed orally are the labial frenectomy (lip-tie) and the lingual frenectomy (for ankyloglossia or tongue-tie). The labial procedure involves cutting the tissue near the upper lip that connects to the gums while the lingual procedure cuts the tissue below the tongue that connects to the floor of the mouth. A dysfunctional frenulum can restrict movement and cause problems with eating and speaking. A lip tie may cause problems with spacing in the front teeth, causing a large gap.
While some insurance companies may consider particular cases “aesthetic” and not necessary to a patient’s health, a frenectomy can significantly improve quality of life for many patients. It can reduce oral discomfort, improve bite function, and result in better speaking ability. For an infant, it can help prevent problems with nursing. Both a labial frenectomy and a lingual frenectomy are usually outpatient procedures that can be performed with topical anesthesia.
Topical Anesthetics from a Compounding Pharmacy
Lidocaine and tetracaine are the most common topical anesthetics used by dentists and orthodontists. Prilocaine may also be included for stronger topical anesthetic formulations. Phenylephrine can be added to a formulation to both decrease systemic effects and increase the duration of the anesthesia by keeping the anesthetic near the site of application longer. Our compounding pharmacy provides multiple formulations of topical anesthetics in different strengths. The stronger anesthetics we use should not be used in a newborn however, and usually not until a patient is at least 2 years old. We do provide some lighter anesthetics that may be more suitable for younger patients. In general a lidocaine 2% cream or EMLA cream is sufficient for numbing.
Benefits of Topical Anesthetics for Frenectomy
Most frenectomies can be performed in-office with the use of topical anesthesia. Performing this minor surgery under general anesthesia can significantly increase costs and decrease patient satisfaction and is not necessary for the majority of patients. With the development of laser technologies that can make the procedure almost painless, there is often not a need for infiltrative anesthesia. A topical anesthetic is sufficient in many cases to ensure patients have a comfortable, pain-free experience.
A topical anesthetic can be especially useful for children and infants and help avoid the use of either general anesthesia or local anesthesia. Many children may be afraid of needles but will likely require some anesthesia even if a laser is being used. A topical anesthetic gel can effectively numb the area without requiring the use of a needle. In a case where infiltrative anesthesia is necessary, a topical anesthetic can be used prior to injection.
How to Use Topical Anesthetic for a Frenectomy
A good way to anesthetize an area before a frenectomy is to apply a topical anesthetic with Q-tips. Two Q-tips should be covered with topical anesthetic then held on either side of the fraenulum. This will help avoid the anesthetic flowing into other areas when you apply it. After holding it on for about 2 minutes, the anesthetic should be cleaned off to prevent sloughing of tissue. Waiting another 2-5 minutes will allow for the full anesthetic effects to work after which the area can be tested for numbness. While this is a standard recommendation for how to apply a topical anesthetic for this procedure, practitioners often come up with their own techniques that work for them.
Research
- Surgical techniques for the treatment of ankyloglossia in children: a case series.
- Upper-lip laser frenectomy without infiltrated anaesthesia in a paediatric patient: a case report.
- Novel local anaesthetic analgesic technique for tongue-tie.
FAQs
How is the procedure completed? First, your baby will be swaddled and a topical anesthetic, such as lidocaine, is applied to the area. The dentist then uses a precise laser to release the tightened or tethered tissue.
Do you go under anesthesia for a frenectomy? ›
Most frenectomies can be performed with only local anesthesia, which numbs either the tongue or lip so that your little one doesn't feel anything when the frena is cut. In very young babies, it may not be necessary to use anesthetic at all since it takes just a few short seconds to perform the procedure.
How long does it take to recover from a frenectomy? ›
After a frenectomy procedure, the surgical site will take around 2-3 weeks to heal completely. The doctor recommends safe aftercare instructions, including feeding, pain management, and surgical area cleaning.
Is a frenectomy a surgery? ›
A frenectomy — sometimes called a frenulectomy — is an oral surgery procedure that treats lip-tie or tongue-tie. During the procedure, your surgeon cuts or modifies a frenum (also called frenulum) — a band of connective tissue that joins two areas.
How painful is frenectomy? ›
Not to worry, a labial frenectomy is a quick and pain-free procedure that is done in one visit. Two methods can be used including laser surgery and traditional surgery.
How painful is laser frenectomy? ›
Laser frenectomy does not hurt. In many cases, the light energy reduces the pain of the procedure and the need for anesthesia. This means no needles and injections.
Will teeth close after frenectomy? ›
When a labial frenectomy is done before their adult teeth grow in, this eliminates the tension that causes the gap in their teeth. Then, as their adult teeth begin to emerge, they will come out in the proper place and maintain proper spacing, eliminating the gap in your little one's smile.
Will a frenectomy close a gap? ›
Frenectomy: An oversized labial frenum may be reduced through minor surgery called a frenectomy. Gaps may close on their own in younger children who've undergone a frenectomy. Older children and adults will generally require additional treatment, like braces, to close gaps after a frenectomy.
What not to do after frenectomy? ›
Avoid extremely hot foods for the rest of the day and do NOT rinse out your mouth, as these will often prolong the bleeding. If bleeding continues, apply light pressure to the area with a moistened gauze or moistened tea bag. Keep in place for 20-30 minutes without looking to see if bleeding has stopped.
What is the average cost of a frenectomy? ›
On average, a frenulectomy costs usually costs between $500 to $1,500; however, the cost will vary greatly depending on the clinic where the frenectomy is performed, whether the procedure can be performed in one visit, and whether sedation is used, and if so, what kind.
At what age should a frenectomy be performed? Each case is different, but the average age at which labial frenectomies are performed is between 8 and 11 years old. Lingual frenectomies are done earlier, as they are performed on babies, sometimes even before they leave the maternity ward.
Will a frenectomy change my smile? ›
A tight frenum can make it hard to clean your teeth. It can also cause oral problems, such as speech and eating difficulties, gaps between the front teeth, and speech problems. But getting a frenectomy can free your lip or tongue, making your smile better.
What are the disadvantages of frenectomy? ›
Despite its effectiveness and low-risk nature, there are some disadvantages of having a frenectomy, which include: Uncontrolled Speech. After a frenectomy, those with tongue tie can find that they have trouble controlling their speech.
What kind of doctor performs a frenectomy? ›
Qualified practitioners include: Dentists: General dentists, pediatric dentists, and orthodontists may perform frenectomies, particularly those involving the labial frenulum. Periodontists: A periodontist like Dr. Scharf, is specifically trained in all areas of periodontal (gum) and oral tissues.
Why is a frenectomy so expensive? ›
The amount of tissue being removed, age of the patient, geographic market of the doctor performing the procedure, and method used in surgery can also impact overall cost. Laser surgery is typically more expensive as it requires a greater level of training and expertise than the traditional scalpel method.
What medication is used for frenectomy? ›
After Frenectomy & Soft Tissue Surgery. PAIN: Some degree of pain is normal for all patients after the procedure. Unless contraindicated, we generally recommend over the counter strength ibuprofen (advil, motrin) and acetaminophen (tylenol).
What is topical anesthesia for tooth extraction? ›
It is available in gel, liquid, ointment, patch and pressurized spray forms. The most common topical anesthetics used in dentistry are those containing benzocaine or lidocaine. Benzocaine (ethyl aminobenzoate) is an ester local anesthetic. It is available in up to 20% concentrations.
What kind of anesthesia is used for tongue tie? ›
Technique. Tongue-tie, when identified in neonates, is typically divided as an in-office procedure, with the use of topical or no anesthesia.
How do you numb for lingual frenectomy? ›
Dr. Zaghi will apply an effective topical anesthetic gel on the frenular tissue underneath the tongue prior to treatment, followed by an injection of lidocaine, allowing for zero to minimal discomfort during the procedure. The anesthetic wears off approximately 30-45 minutes after the procedure is completed.
